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All Journal Damianus Journal of Medicine ISM (Intisari Sains Medis) : Jurnal Kedokteran The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Indonesian Journal of Cancer Jurnal Penyakit Dalam Indonesia International Journal of Psychology and Health Science Frontiers on Healthcare Research
Jeo, Wifanto Saditya
Department Of Anesthesiology And Intensive Care, Faculty Of Medicine, Universitas Indonesia, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Tumor Microenvironment in Colorectal Cancer Development: A Review of 3D Study Analysis Angka, Rebecca Noerjani; Sudoyo, Aru Wisaksono; Siregar, Nurjati Chairani; Jeo, Wifanto Saditya; Antarianto, Radiana Dhewayani
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1089

Abstract

Background: Colorectal cancer is the third most common cancer in 2020, with a high mortality rate. Colorectal cancer treatment has made many advances. However, many factors in the tumor microenvironment still have not been reached but significantly affect the success of treatment. This literature review was conducted to search for research articles that analyze factors in the tumor microenvironment, how they interact through studies primarily conducted in 3D, and how to prepare for 3D research on colorectal cancer will be briefly discussed. The aim of this systematic review is to study the components of the tumor microenvironment in colorectal cancer development as assessed by 3D studies. Methods: Article searches were conducted through Embase, Scopus and PubMed. From the 110 articles found at the beginning of the search, after going through several screening stages, 27 articles were determined that met the inclusion criteria. The inclusion criteria used were journals containing research articles on colorectal cancer in the last five years with topics regarding the tumor microenvironment and according to keywords. Results: Microenvironment components in colorectal cancer, consisting of cellular and noncellular components, have the most significant effect on cancer development and ultimately affect metastasis, response to treatment, and prognosis.  Conclusions: This literature review proves that the components of the tumor microenvironment are very diverse, making colorectal cancer heterogeneous. It still requires a lot of research to prove the existence of other components that affect the effectiveness of the treatment.
Comparison of Outcomes between Laparoscopy and Laparotomy in Colorectal Cancer at Dr. Cipto Mangunkusumo Hospital Wifanto Saditya Jeo; Hutomo Rezky Noorsukma
Indonesian Journal of Cancer Vol. 20 No. 1 (2026): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i1.1516

Abstract

Background: Colorectal cancer (CRC) is one of the most common types of cancer in the world and a leading cause of cancer-related deaths. Laparotomy is the standard curative treatment for localized disease. Laparoscopy offers several advantages, including less postoperative pain, shorter hospital stays, faster recovery, and lower risk of infection. Therefore, we conducted this study to evaluate the outcomes of laparoscopy versus laparotomy in CRC, particularly at Dr. Cipto Mangunkusumo Hospital, Jakarta. Methods: This retrospective study included CRC patients who underwent laparoscopy (56 subjects) and laparotomy (79 subjects) from 2022 to 2024 in Dr. Cipto Mangunkusumo Hospital. Inclusion criteria were: patients aged over 18 years, diagnosed with stage I—III colorectal cancer, and treated with either laparoscopic or open surgical resection. The outcomes were hospital stay, intraoperative blood loss, complications, surgical duration, and surgical fee. Chi-square test was used for categorical variables, and the independent T-test was used for continuous variables.Results: A total of 135 CRC patients (54.8% female) with a mean age of 54.74±12.90 years old were recruited in this study. Nearly half of the patients (49.6%) had tumors located in the rectum. We found that laparoscopy was associated with a lower risk of postoperative complications (OR = 0.091; 95%CI 0.011—0.777; p = 0.008) and a lower risk of 2-year mortality (OR = 0.395; 95% CI 0.178—0.878; p = 0.054). We found no significant difference between hospital stay, intraoperative blood loss, surgical duration, and surgical cost in bivariate analysis. Multivariate analysis revealed significant differences in surgery duration (B -0.196; p = 0.025) and surgical fee (B 0.263; p = 0.028), with no significant differences in blood loss, postoperative complications, treatment duration, and 2-year mortality rate.Conclusions: Laparoscopic surgery offers significant lower risk of postoperative complications. Although it was not statistically significant, we also found that laparoscopy had a lower trend of 2-year mortality. These findings support the use of laparoscopy as a safe approach for appropriately selected patients, though further studies are warranted in complex and advanced cases.
An Integrative Approach to Autophagy and Oxidative Stress Pathways for Clinical Prediction in Colorectal Cancer: A Narrative Review Welly Hartono Ruslim; Himmi Marsiati; Nunung Ainur Rahmah; Wifanto Saditya Jeo
International Journal of Psychology and Health Science Vol. 4 No. 3 (2026): International Journal of Psychology and Health Science (July - September 2026)
Publisher : Greenation Publisher & Yayasan Global Research National

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijphs.v4i3.2264

Abstract

Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Increasing evidence suggests that oxidative stress and autophagy are interconnected biological processes involved in tumor initiation, progression, therapeutic resistance, and patient survival. However, their combined role as an integrated prognostic biomarker panel has not been comprehensively reviewed. This narrative review aimed to summarize current evidence on the interaction between oxidative stress and autophagy pathways and to evaluate the clinical potential of their biomarkers for prognostic prediction in CRC. This review was based on peer-reviewed open access publications from major scientific databases between 2019 and 2025. Studies that have assessed oxidative stress biomarkers, such as 8-hydroxy-2′-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE), nuclear factor erythroid 2-related factor 2 (NRF2), Kelch-like ECH-associated protein 1 (KEAP1), and autophagy-related biomarkers, including microtubule-associated protein 1 light chain 3 beta (LC3B) and sequestosome 1 (p62/SQSTM1) were critically synthesized. Current evidence suggests a role for oxidative stress and autophagy dysregulation in the development of CRC. Increased expression of LC3B, p62/SQSTM1, NRF2, and 8-OHdG is always associated with advanced disease, treatment resistance, tumor recurrence, and poor overall survival. Integrating biomarkers from both pathways appears to improve prognostic accuracy compared with individual biomarkers. Combined assessment of oxidative stress and autophagy biomarkers represents a promising prognostic approach for CRC. Nevertheless, large prospective studies are required to validate their clinical utility before routine implementation in precision oncology.
Effect of Preoperative Lactobacillus acidophilus Supplementation on Postoperative Gastric Residual Volume after Lower Digestive Laparotomy: A Randomized, Double-Blind, Controlled Trial Christophorus Simadibrata; Rudyanto Sedono; Sidharta Kusuma Manggala; Wifanto Saditya Jeo
Frontiers on Healthcare Research Vol. 3 No. 2 (2026)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v3.n2.p22-30.2026

Abstract

Background: Gastrointestinal dysmotility is among the most common complications after abdominal surgery and is reflected clinically by an elevated gastric residual volume (GRV), which increases the risk of aspiration and delays enteral feeding. Lactobacillus acidophilus is thought to improve gut motility through luminal acidification, competitive exclusion of pathogens, and direct stimulation of smooth-muscle contractility, but whether this translates into a lower GRV after digestive laparotomy has not been tested. Objective: To determine whether preoperative Lactobacillus acidophilus supplementation reduces postoperative GRV after lower digestive laparotomy. Methods: In this randomized, double-blind, placebo-controlled trial at Dr. Cipto Mangunkusumo National General Hospital, Indonesia, adults scheduled for elective laparotomy of the jejunum, ileum, colon, or rectum received oral Lactobacillus acidophilus 10⁹ CFU or an identical placebo capsule three times daily for three days before surgery. A nasogastric tube inserted during surgery was aspirated every 6 hours after ICU admission; GRV was categorized as normal (<250 mL/24h) or increased (≥250 mL/24h) at 24 and 48 hours. Results: Fifty-five participants were randomized (27 probiotic, 28 placebo); one placebo-group participant was withdrawn because of sepsis, leaving 54 participants analyzed per protocol. GRV was increased in 4/27 (14.8%) probiotic recipients versus 2/27 (7.4%) placebo recipients at 24 hours (p = 0.669; risk ratio for normal GRV 0.92, 95% CI 0.76–1.11) and in 1/27 versus 0/27 at 48 hours (p = 1.000). Stratified analysis identified age, neurological comorbidity, obesity, vasopressor use, opioid exposure, hypercapnia, and hyperglycemia as confounders that shifted the crude risk estimate by more than 10%; opioid and vasopressor exposure were also unevenly distributed between groups at baseline (p = 0.006 and p = 0.026, respectively). Conclusion: A 3-day preoperative course of Lactobacillus acidophilus did not significantly reduce postoperative GRV after lower digestive laparotomy. The trial was underpowered relative to its planned sample size, and an uneven distribution of opioid and vasopressor exposure between groups may have obscured a true effect.
Co-Authors Agi Satria Putranto Ananti, Anggini T. Angka, Rebecca Noerjani Aria Kekalih Christophorus Simadibrata Devby Ulfandi Francis Celeste Gurmeet Singh Harini Oktadiana Harini Oktadiana, Harini Himmi Marsiati Hutomo Rezky Noorsukma I Made Yudi Mahardika Ibrahim Basir Kuntjoro Harimurti Lumban Tobing, Demak Maelissa Pramaningasih Manggala, Sidharta Kusuma Mazni, Yarman Noto Dwimartutie Nunung Ainur Rahmah Nurjati Chairani Siregar Pramaningasih, Maelissa Primadhani, Wendy Radiana Dhewayani Antarianto Ramdhani, Aris Retno Asti Werdhani Rony - Rudyanto Sedono Sudoyo, Aru Wisaksono Suharto, Wuryantoro Ulfandi, Devby Welly Hartono Ruslim Yefta Moenadjat Yoladifa, Safira Farah Yusak Kristianto